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Abstract
<p class="first" id="d9124405e61">A list presenting a valid ranking of drugs most
commonly implicated is hardly to be
found. Areas covered: Published cases of drug-induced liver injury (DILI) with verified
causality using RUCAM (Roussel Uclaf Causality Assessment Method) were used for a
ranking of drugs most commonly implicated in causing DILI. Expert opinion: RUCAM-based
DILI cases were retrieved from 15 reports published by six international databases
of DILI registries and three large medical centers, which provided 3312 cases. Overall
48 drugs with the highest number of DILI cases were listed. Among the top 10 ranking
drugs implicated in causing DILI were, in decreasing order: amoxicillin-clavulanate,
flucloxacilllin, atorvastatin, disulfiram, diclofenac, simvastatin, carbamazepine,
ibuprofen, erythromycin, and anabolic steroids as bodybuilding agents. For these 10
drugs, respective DILI case numbers were highest for Amoxicillin-clavulanate (n=333)
and lowest for anabolic steroids (n=26). The author classifies the databases of national
DILI registries and large medical centers as best sources of drugs implicated in DILI.
Presently discouraged is the use of the LiverTox website because many cases were derived
from published cases of poor quality and could previously not be classified as DILI,
calling for the inclusion of DILI cases with established causality by the updated
RUCAM.
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